HYSTEROSCOPY REPORT SCRIPT

So, for our disposition and future plans, usually after procedures such as
hysteroscopy, patients are able to go home the same day as the surgery
is done. However, we need to keep in mind of course the possible
lingering side effects of the anesthesia used therefore, the patient may
stay in the hospital for a few hours until these effects have worn off.

After the procedure, the patient can be advised that they continue their
diet as tolerated, however it would be better to incorporate fiber in the
diet to stimulate the bowel movement and to avoid straining. It is also
important to remind the patient to remain hydrated.

During the procedure, as what was mentioned earlier in the discussion,

the cervix is dilated to allow for the instruments to be used inside the
uterus. Hence, to prevent bacteria from entering this area, we should
advise our patient to not use anything vaginally for at least two weeks.
This includes the usage of tampons, douching, and even intercourse.
This is also to allow the healing of the tissues. Your patients might be
curious and ask if they can take a bath after the procedure. You can
advise the patient that they can already take a shower unless they feel
uncomfortable to do so. However, we should remind them that it is best
to avoid soaking in a tub or swimming as bacteria in the water can enter
the uterus in this way and may cause infections.

We should also inform the patient that she may experience

postoperative cramping which may resemble the cramping that are
experienced during menstruation, and even some vaginal discomfort.
That is why analgesics may be taken for post-operative pain control.
NSAIDS such as Ibuprofen may be given and for most patients this
seems to work best to control post- operative pain. We should also
inform the patient that this cramping pain usually resolves spontaneously
within a few days.

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There may also be small amount of bleeding after the procedure which
can last up to a few days up to a week or more. However, we should
inform our patient that this bleeding should not be heavier than a light
menstrual period and can usually just be seen as spotting and will
probably resolve spontaneously within a few days. As mentioned earlier,
they should not use any tampons, however, panty liners are acceptable
to be used, but must still be changed regularly to avoid possible
infection.

The patient may also resume her normal activities usually within 24
hours or once she is comfortable. However, it is best to avoid strenuous
activities or any sports for about a week after the surgery but may
resume with the normal routine at home, like walking, stretching, or
simple tasks to get back to their normal energy level more quickly.

Perineal care should also be advised. Patient should thoroughly wash

the external genitalia, washing in the direction of perinium to rectum and
to dry the area thoroughly.

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We should also watch out for possible complications and advise the
patient to return for follow up immediately if she experiences any fever,
progressively worsening abdominal pain, heavy vaginal bleeding, and
yellow or greenish and foul- smelling discharge after the procedure.

Since our patient has mild anemia, it is recommended by the ACOG that
women should receive oral iron administration as the preferred route of
treatment and to continue taking iron supplements for up to 3 months.

In this case, we already know the histopathology results of our patient,

but in the event that we do not have the results yet, we should advise
the patient to follow up 2 weeks after the procedure of once with the
histopathology results. For now, we should inform our patient that since
we have completely removed the cause of her heavy menstrual
bleeding, then her symptoms should resolve and that we shall continue
observing her bleeding patterns and if she would experience continued
heavy bleeding, then this would warrant for further evaluation.

 Remain in the semi recumbent position for several minutes to reduce vasovagal episodes
o Vasovagal episodes can happen since the patient is given anesthetic medications.
May result in lightheadedness, palpitations, nausea, episodes of fainting.
 Patient may experience postoperative cramping, light bleeding or vaginal discomfort
o Acetaminophen or NSAIDs are given for postoperative pain control
o Avoid alcoholic beverages if taking pain medications
 May interfere with pain medications
o Tampons should not be used however pads are allowed.
 May be a source of infection and microorganisms to grow
 Early ambulation and normal activities can be resumed if comfortable or within 24 hours.
 Sexual activities should be avoided 2-6 weeks after the procedure to allow healing of the
tissues.
 High fiber diet is recommended to avoid straining or constipation
o Since patient can be prone to compromise of bowel movement. To stimulate bowel
movement and avoid straining.
 Avoid swimming and tub baths as well as douching
 Observe proper perineal hygiene.
 Watch out for fever, severe abdominal pain, and heavy vaginal bleeding and discharge.
 Follow up appointments can be done 2 weeks after the procedure for holistic assessment and
review pathology results.